Mind Over Math - Summer Camp 2024

Summer Camp 2024

Please complete the following summer camp enrollment form. This form must be submitted along with an initial deposit in order to reserve your child's spot in our summer camp program.

Parent Information

First Name

Last Name

Confirm Email

Additional Email (optional)

Home Phone

Mobile Phone

Address

Address Line 2 (optional)

City

State

Zip

Alternate Contact (in case of emergency)

Enrollment Agreement

CODE OF CONDUCT
To ensure that everyone has a positive experience while participating in a camp or program provided by Mind Over Math, students attending the program are expected to behave in a disciplined, responsible and respectful manner. Failure to follow these rules and regulations will subject the students to immediate disciplinary action as described more fully below.

Students Will:
- respect Mind Over Math staff requests and follow all of their directions with a positive attitude;
- respect all safety guidelines required by Mind Over Math staff including prescribed locations and boundaries;
- respect all program changes made based on weather or safety related considerations;
- wear appropriate clothing and closed-toe shoes during all activities;
- respect the differences in other people, make an effort to include everyone;
- pick-up after themselves and throw all trash away;
- respect other people’s personal property and privacy;
- respect all Mind Over Math and Long Leaf Park property including equipment, building and the campus;
- let their program counselor know if they are not having a good time;
- immediately bring disagreements to the attention of Mind Over Math staff;
- behave in an age-appropriate manner.

Students Will Not:
- share/swap food during snack or lunch (due to health/dietary/allergy concerns)
- fight, tease, bully, or in any way attempt to intimidate other students using any part of their body, gestures or words;
- behave in a manner that may hurt another student or staff member’s feelings;
- put themselves, other students or Mind Over Math staff at risk;
- go anywhere without the permission and accompaniment of counselors;
- use derogatory terms or offensive language at any time;
- bring inappropriate items with them to camp;
- bring any type of electronic equipment that is prohibited, which include: tablets, laptops, iPads, etc;
- Students may not use cell phones during the program; they may not be used as cameras (if a parent requires their camper to have a cell phone, it must be kept in the camper’s backpack/bag and be set on silent; Mind Over Math is not responsible for cell phones brought to camp.)

Parents Will:
- provide all necessary camper information (related to differences in behavioral, physical, learning abilities) to ensure that their child has a safe and positive program experience and inform Mind Over Math staff of the best way to interact with/manage their child;
- review the Student Code of Conduct with their child prior to arrival at Mind Over Math.

Parents Will Not:
- interact with Mind Over Math staff in a threatening/abusive manner at any time (in person or on the phone) or their child will be dismissed from the program without tuition/fee refund.
- interact with campers or their parents in a threatening/abusive manner at any time (in person or on the phone) or their child will be dismissed from the program without tuition/fee refund;

PAYMENT
Tuition for each summer camp session is $225. A $30 sibling discount will be applied for each additional child enrolled. Payment must be made by the invoice due date or Mind Over Math reserves the right to cancel your child's enrollment.

CANCELLATION POLICY
- No refunds will be given within 2 weeks prior to the start date of your camp session.
- A 50% refund will be given 2-4 weeks prior to start date of camp (50% cancellation fee).
- A 25% processing fee (per student) will be charged for any cancellations made more than 4 weeks prior to start date of camp.
- $25 processing fee for any changes in dates (space permitting in another Mind Over Math Summer 2022 camp)
- Mind Over Math reserves the right to cancel a camp session in the unlikelihood of low enrollment while providing notice at least two weeks in advance and a full refund.

MEDICAL INFORMATION
If your student has any pertinent medical information, please specify in the box marked "Additional Information" below. Please include any allergies, medications and special needs. This information will be kept confidential and will only be accessed by staff on a need-to-know basis.

RELEASE OF LIABILITY
With acceptance to attend Mind Over Math, I hereby release Mind Over Math Tutoring and all personnel, partners and sponsors connected with Mind Over Math or the programs it sponsors from any liability, illness or property damage that I sustain during my participation in this program or that is in any way related to this program. I understand that this applies to myself, my child and our respective successors and personal representatives. I hereby authorize the directors and staff of Mind Over Math Tutoring to provide or retain medical care and to obtain emergency medical attention. I accept responsibility for the payment of any medical treatment which may be required. My child is physically fit to participate in program activities according to our family physician.

MINORS
Where the Student is a legal minor, the Parent/Guardian shall enter into this tutoring contract on behalf of the Student and shall accept and agree to all the terms and conditions contained herein on behalf of the Student.

TERMINATION
Enrollment may be cancelled by either party by giving the other party (14) fourteen days prior written notice.

RELAXATION OF TERMS
No relaxation, indulgence, waiver or release by any party of any of the rights in terms of this agreement on one occasion shall prevent the subsequent enforcement of such rights and shall not be deemed to be a waiver of any subsequent breach of any of the terms.

WHOLE AGREEMENT
This agreement constitutes the entire understanding between the parties with regard to the subject matter thereof and the parties waive the right to rely on any alleged expressed or implied provision not contained herein. Any alteration to this agreement must be in writing and signed by both parties.

I acknowledge that I have read the above policies thoroughly. I clearly understand and agree to all terms and conditions upon enrolling my child in Mind Over Math's summer camp program.

Credit Card Details

Invoices will be delivered via email. Mind Over Math provides the option for automatic payment authorization below. Payment information will not be shared with any unauthorized parties.

Billing Options One payment - full tuition charged upon enrollmentTwo Installments - 50% of tuition per payment

AutoPay Authorization Mind Over Math is authorized to automatically charge the credit card on file for each invoice

Promo Code

Camp Selection

I would like to enroll my child in the following camp(s):

Age Group

Student Information

First Name

Last Name

School

Current Grade

Medical Information - If your student has any pertinent medical information please specify in the box below. Include any allergies, medications, etc. This information will be kept confidential and will only be accessed by staff on a need-to-know basis. If none, please enter N/A.

Birth Date

Additional Information Mind Over Math should know about your child to ensure a positive camp experience

Student Code of Conduct

I understand and acknowledge (by checking below) that if I choose not to follow the Student Code of Conduct that: First offense - Student will be given a verbal warning explaining the expected behavior; Second offense - Student will be removed from the activity and parent/guardian will be called to discuss the behavior. Third offense - Parent or guardian will be called notifying them of student's dismissal from program. I understand that Mind Over Math has a ZERO TOLERANCE policy for some actions (see Welcome Packet). In these cases, students will be immediately dismissed and will not receive a program refund. I understand and acknowledge the Student Code of Conduct.

Media Release

I agree that my minor child may be photographed, audio taped or videotaped by Mind Over Math. I agree that the photographic image(s), audio and video recordings may be disseminated for any public release usage (including social media) by Mind Over Math with no pre-approval or compensation. I also hereby release Mind Over Math, its agents and employees from all claims, demands and liability whatsoever in connection with the above. By selecting one of the following options, I certify my agreement with the above stated media and liability release under the following terms: Yes. My child's photograph or video may be reproduced and released for use in the media as described above. I also grant permission for my child's name and photo to be used to create special badges or awards for use during camp sessions.Yes. I grant permission for my child's name and photo to be used to create special badges or awards for use during camp sessions. I do not authorize any other use.No. My child's photo or video may not be reproduced and released for use in the media. I prefer that my child be issued badges or awards without a photo for use during camp sessions.

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